Search

ABSTRACTPosaconazole (PCZ), approved for prophylaxis against invasive fungal disease in high-risk patients, is commercially available orally as a suspension formulation (PCZ-susp) and as a delayed-release tablet (PCZ-tab). We evaluated the serum steady-state concentrations (Css) of PCZ stratified by the administered formulation for antifungal prophylaxis in patients with myeloid malignancies (n= 150). The primary outcome was the attainment rate of the target Cssof ≥700 ng/ml. Secondary outcomes included toxicity assessment (hepatotoxicity and corrected QT [QTc] interval prolongation) and breakthrough fungal infections. Patients who received the PCZ-susp (n= 118) or PCZ-tab (n= 32) and had PCZ Cssassessment after at least 7 days of therapy were eligible. The median Cssin the PCZ-susp group was 390 ng/ml (range, 51 to 1,870 ng/ml; mean, 436 ng/ml) compared to 1,740 ng/ml (range, 662 to 3,350 ng/ml; mean, 1,781 ng/ml) in the PCZ-tab group (P< 0.0001). The percentages of patients achieving the target goal of ≥700 ng/ml were 17% versus 97%, respectively (P< 0.0001). Hepatotoxicity (grade 2 or higher) occurred in 1 patient in each group. QTc interval measurements were available for 32 patients in the PCZ-susp group and for 12 patients in the PCZ-tab group, and prolonged intervals of grade 2 or higher were noted in 9% (n= 3) and 17% (n= 2), respectively (P= 0.6). Breakthrough fungal infections in the PCZ-susp and PCZ-tab groups were 7% (n= 8) and 3% (n= 1), respectively (P= 0.68). We conclude that the use of PCZ-tab was associated with higher Cssand with the probability of achieving therapeutic goals without worsening of adverse effects.

The 95° angled blade plate is an accepted standard for plating subtrochanteric femoral fractures but can be technically demanding and often requires extensive soft tissue exposure. Proximal femoral locking plates (PFLPs) have been developed for subtrochanteric and pertrochanteric fractures and are potentially easier to apply with less soft tissue dissection. Clinical experience has raised concerns regarding the strength of the PFLP. The purpose of our study was to compare the relative stability of two designs of PFLP with the 95° angled blade plate under loads simulating the first 3 months of progressive weight bearing after fracture fixation.

Grunwald: Forma Therapeutics:Research Funding;Agios:Consultancy;Abbvie:Consultancy;Trovagene:Consultancy;Daiichi Sankyo:Consultancy;Astellas:Consultancy;Daiichi Sankyo:Consultancy;Trovagene:Consultancy;Trovagene:Consultancy;Premier:Consultancy;Astellas:Consultancy;Astellas:Consultancy;Genentech/Roche:Research Funding;Premier:Consultancy;Genentech/Roche:Research Funding;Genentech/Roche:Research Funding;Premier:Consultancy;Janssen:Research Funding;Merck:Consultancy;Forma Therapeutics:Research Funding;Incyte:Consultancy, Research Funding;Celgene:Consultancy;Incyte:Consultancy, Research Funding;Incyte:Consultancy, Research Funding;Pfizer:Consultancy;Celgene:Consultancy;Celgene:Consultancy;Cardinal Health:Consultancy;Merck:Research Funding;Daiichi Sankyo:Consultancy;Agios:Consultancy;Abbvie:Consultancy;Merck:Consultancy;Amgen:Consultancy;Merck:Consultancy;Amgen:Consultancy;Abbvie:Consultancy;Pfizer:Consultancy;Amgen:Consultancy;Pfizer:Consultancy;Agios:Consultancy;Cardinal Health:Consultancy;Forma Therapeutics:Research Funding;Cardinal Health:Consultancy;Janssen:Research Funding.Ai:Incyte:Speakers Bureau;Celgene:Speakers Bureau.Knight:Foundation for Financial Planning:Research Funding.Chojecki:Incyte:Research Funding;Novartis:Other: Investigator Meeting Attendance.Avalos:Juno:Membership on an entity's Board of Directors or advisory committees;Best Practice-Br Med J:Patents & Royalties: receives royalties from a coauthored article on evaluation of neutropenia.Copelan:Amgen:Membership on an entity's Board of Directors or advisory committees.

Introduction:

The preservation of a severely damaged tooth with a cast restoration requires that the preparation be modified to make use of remaining tooth structure. Preexisting preparation features, such as boxes and isthmuses, and new ones, such as boxes, grooves, and pin holes, are employed to provide adequate retention and resistance. When destruction of coronal tooth structure exceeds one-half of the clinical crown, a pin-retained amalgam or composite resin core should be used to build up the tooth to receive a cast restoration.

Partial veneer crowns still play a role in modern restorative dentistry. They must be used in the right situation with thoughtful treatment planning, and they must be done well in accordance with certain principles.

A total of 3,737 dentists were surveyed to disclose preferences for specific impression material. Data on use of stock or full-arch trays and pouring times were also collected and compared.

Because of physiologic tooth movement, arch position of the abutments, and the retentive capacity of the retainers, a nonrigid connector may be preferred in the fabrication of a five-unit pier-abutment fixed partial denture. In this prosthesis, the movement of the nonrigid connector is enough to prevent the middle abutment from serving as a fulcrum. Tooth preparation and the fabrication of precision and semiprecision attachments are described.

A satisfactory temporary restoration must protect the pulp of the tooth from external stimuli; must maintain the position of the tooth; must maintain correct occlusion; and must be constructed so that it can be cleaned easily by the patient. The temporary restoration also must be strong and it should remain intact when removed so that it can be reused if necessary. A method of curing a temporary acrylic restoration on a cast of the tooth is described.

No relevant conflicts of interest to declare.

HPC mobilization with plerixafor (Plex) plus G-CSF (G+P) results in superior CD34+ cell yield, when compared to mobilization with G-CSF alone in patients with myeloma and lymphoid malignancies. However, Plex-based approaches are associated with high mobilization costs. To circumvent higher costs, several institutions use a so-called JIT approach, where Plex is only administered to patients likely to fail mobilization with G-CSF alone. Whether such a JIT-Plex approach is cost effective has not been confirmed to date. We present here, a single institution comparative analysis of 137 patients with myeloma and lymphoma who underwent mobilization with 2 different approaches of Plex utilization. Between Jan 2010-Oct 2012 (n=77) patients received mobilization G-CSF (10 μg/kg) for 5 days and Plex (0.24 mg/kg) on the evening of day four, 11 hours before apheresis the following day (G+P). To reduce mobilization costs between Nov 2012-Jun 2014 (n=60) patients were mobilized with JIT-Plex where Plex was only administered to patients likely to fail mobilization with G-CSF alone (i.e. patients with a day 4 peripheral blood (PB) CD34+ count of <10/μL, or those with day 1 yield of < 1.0 X 106cells/kg or day 1+2 yield of <1.5 X 106cells/kg ABW. Mobilization failure was defined as inability to collect at least 2 X 106/kg CD 34+ cells. Patients in G+P had a higher mean peak PB CD34+ cell count (77 vs. 33.1 cells/μL, p<0.001) and a higher mean CD34+ cell yield on day 1 of collection (4.4 X 106vs. 2.4 X 106cells/kg ABW, p=0.0005). The mean total CD34+ cell collection was also higher in G+P (6.64 X 106vs. 4.81 X 106cells/kg ABW, p=0.0068). In the JIT-Plex group 41% (n=24) completed adequate HPC collection without Plex. Mobilization failure was noted in 5 patients in the G+P group (3 were salvaged with bone marrow harvest) and 2 patients in the JIT-Plex group. Two patients in either group did not proceed to AHCT as a result of mobilization failure. The mean Plex doses utilized in JIT-Plex was lower (1.3 vs. 2.1, p=0.0002), however 21% (n=16) in the G+P group completed apheresis on day 1 compared to only 6.9% (n=4) in JIT-Plex, p=0.0094. Cost analysis was estimated based on actual sales price (actual wholesale price AWP – (AWP X 0.2)) for mobilization agents and the United states (US) Department of Health and Human Services Centers for Medicaid Services (HHS/CMS) reimbursement rates for procedural costs associated with mobilization, apheresis or cryopreservation. The mean estimated cost was higher in the G+P group ($28,448 vs. $24,852, p=0.0315). Our analyses, for the first time confirms that mobilization with JIT-Plex allows for a safe, adequate and cost efficient strategy for HPC collection.

Shares some thoughts on kitchen gardening. Significance of sustained gardening for the gardener; Impact of the garden on the diet; Basic principles of sustainable food gardening.

The article discusses the importance of understanding people's attitudes about the common food system and the businesses and industries that create and manage it. The author suggests how to effect changes in the food system. An explanation for the public's notions about food system is presented. Views on people as food consumers are provided.

The article provides information on the author's data and reports on the Native Seed SEARCH--Gardener's Network program. Details of the contents of the report are presented.

The article provides tips on how determine how much is enough for food consumption and gardening. The basic principles of gardening are presented. The things that should be considered such as garden space and food needs are discussed.